Frailty in older men: prevalence, progression, and relationship with mortality

J Am Geriatr Soc. 2007 Aug;55(8):1216-23. doi: 10.1111/j.1532-5415.2007.01259.x.


Objectives: To describe the association between frailty and health status, the progression of frailty, and the relationship between frailty and mortality in older men.

Design: Cross-sectional and prospective cohort study.

Setting: Six U.S. clinical centers.

Participants: Five thousand nine hundred ninety-three community-dwelling men aged 65 and older.

Measurements: Frailty was defined as three or more of the following: sarcopenia (low appendicular skeletal mass adjusted for height and body fat), weakness (grip strength), self-reported exhaustion, low activity level, and slow walking speed. Prefrail men met one or two criteria; robust men had none. Follow-up averaged 4.7 years.

Results: At baseline, 240 subjects (4.0%) were frail, 2,395 (40.0%) were prefrail, and 3,358 were robust (56.0%). Frail men were less healthy in most measures of self-reported health than prefrail or robust men. Frailty was somewhat more common in African Americans (6.6%) and Asians (5.8%) than Caucasians (3.8%). At the second visit, men who were frail at baseline tended to remain frail (24.2%) or die (37.1%) or were unable to complete the follow-up visit (26.2%); robust men tended to remain robust (54.4%). Frail men were approximately twice as likely to die as robust men (multivariate hazard ratio (MHR)=2.05, 95% confidence interval (CI)=1.55-2.72). Mortality risk for frail men was greater in all weight categories than for nonfrail men but was highest for normal-weight frail men (MHR=2.39, 95% CI=1.51-3.79, P for interaction=.01). The relationship between frailty and mortality was somewhat stronger in younger men than older men (P for interaction=.01).

Conclusion: Frailty in older men is associated with poorer health and a greater risk of mortality.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Cross-Sectional Studies
  • Disease Progression
  • Frail Elderly / statistics & numerical data*
  • Humans
  • Male
  • Mortality / trends*
  • Prevalence